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BACKGROUND: Using the newer lower limit of normal criterion instead of the conventional cutoff values to define pulmonary function abnormalities may result in different predictors of pulmonary function impairment in patients with heart failure. Therefore, we assessed predictors of pulmonary function impairment in subjects with chronic heart failure according to the lower limit of normal in comparison with conventional cutoff values. METHODS: In this prospective cross-sectional study, 164 chronic heart failure subjects (age 68 ± 10 y, 78% men, 88% New York Heart Association class I-II) with left ventricular ejection fraction <40% underwent pulmonary function tests. Predictors of pulmonary function impairment were assessed using the lower limit of normal and conventional cutoff values (ie, 80% predicted value and the fixed ratio of FEV1/FVC <0.7). RESULTS: The lower limit of normal criterion identified an extra independent predictor of diffusion impairment compared with the 80% predicted value; in addition to body mass index, pack-years, and alveolar volume, female sex also turned out to be an independent predictor. A smoking history of ≥ 10 pack-years was a significant predictor of diffusion impairment and airway obstruction using the lower limit of normal criterion but not using the conventional cutoff values. However, lowering the cutoff points of conventional criteria to match the more stringent lower limit of normal and thus avoid overdiagnosis of diffusion impairment and airway obstruction in the elderly produced similar results as the lower limit of normal. CONCLUSIONS: The lower limit of normal identifies more predictors of diffusion impairment and airway obstruction compared with conventional cutoff values in subjects with chronic heart failure with left ventricular systolic dysfunction. However, lowering the conventional cutoff points yielded similar results as the lower limit of normal. [ABSTRACT FROM AUTHOR]

In the literature it is questioned if the presence of maxillofacial trauma is associated with the presence of brain injury. The aim of this study is to present a 10-year retrospective study of the incidence and aetiology of maxillofacial trauma associated with brain injury that required both oral and maxillofacial and neurosurgical intervention during the same hospital stay. Forty-seven patients from a population of 579 trauma patients undergoing maxillofacial surgery were identified. The main cause of injury was road traffic collision, followed by falls. Interpersonal violence correlated less well with traumatic brain injury. Most of the patients were males, aged 20–39 years. Frontal sinus fractures were the most common maxillofacial fractures (21.9%) associated with neurosurgical input, followed by mandibular fractures and zygomatic complex fractures. In the general maxillofacial trauma population, frontal sinus fractures were only found in 2.2% of the cases. At presentation to the Emergency Department the majority of the patients were diagnosed with severe traumatic brain injury and a Marshall CT class 2. Intracranial pressure monitoring was the most common neurosurgical intervention, followed by reconstruction of a bone defect and haematoma evacuation. Although it is a small population, our data suggest that maxillofacial trauma does have an association with traumatic brain injury that requires neurosurgical intervention (8.1%). In comparison with the overall maxillofacial trauma population, our results demonstrate that frontal sinus fractures are more commonly diagnosed in association with brain injury, most likely owing to the location of the impact of the trauma. In these cases the frontal sinus seems not specifically to act as a barrier to protect the brain. This report provides useful data concerning the joint management of oral and maxillofacial surgeons and neurosurgeons for the treatment of cranio-maxillofacial trauma and brain injury patients in Amsterdam. [ABSTRACT FROM AUTHOR]

This study examines the construct validity of the Young Schema-Questionnaire at the item level in a Dutch population. Possible bias of items in relation to the presence or absence of psychopathology, gender, and educational level was analyzed, using a cross-validation design. None of the items of the YSQ exhibited differential item functioning (DIF) for gender, and only one item showed DIF for educational level. Furthermore, item bias analysis did not identify DIF for the presence or absence of psychopathology in as much as 195 of the 205 items comprising the YSQ. Ten items, however, spread over the questionnaire, were found to yield relatively inconsistent response patterns for patients and nonclinical participants. [ABSTRACT FROM AUTHOR]

The number of children displaying childhood disorders in the Netherlands is estimated through a questionnaire referencing DSM-IV symptoms filled out by the parents of 2,563 4- 18-year-old Dutch children randomly taken from the general Dutch Youth population in 2004. The number of impaired children was estimated by applying the DSM-IV criteria for impairment by symptoms. It was found that 14% of all Dutch children display developmental difficulties, with 8% at risk of moderate behavioral and emotional difficulties and 6% at risk of a childhood psychiatric disorder. These prevalence figures based upon parental observations of DSM-IV symptoms in children are in agreement with the findings of other studies estimating psychiatric disorders in childhood in Western countries. [ABSTRACT FROM AUTHOR]

Abstract: The Land Use Scanner (LUS) is a decision support system for land use planning that is widely used in the Netherlands. The model yields solutions that have a high resolution (500×500m) and reflect economic equilibrium in the land market, in which eighteen types of land use and nine aggregated habitat types competitively bid for locations. Here, an extension to the LUS is presented that enables the internalisation of environmental externalities. The focus in this study is on two important externalities, namely ammonia emissions from agriculture and habitat fragmentation. We simulate four IPCC-based land use scenarios and assess the level of fragmentation of the nine habitat types. We also perform sensitivity analyses in the most market-oriented scenario on the effectiveness of market-based instruments in promoting more efficient land allocation. The simulation results suggest that particularly the habitat type ‘rain-fed mires and bogs’ is susceptible to fragmentation. The sensitivity analyses show that internalising the damage costs of fragmentation resulted in smaller changes in land allocation than internalising those of nitrogen deposition. For both instruments, the policy effort was large in relation to the efficiency gains in land allocation. [Copyright &y& Elsevier]

Abstract: Introduction: The incidence of maxillofacial fractures varies widely between different countries. The large variability in reported incidence and aetiology is due to a variety of contributing factors, including environmental, cultural and socioeconomic factors. This retrospective report presents a study investigating the aetiology and incidence of patients with maxillofacial fractures in Amsterdam over a period of 10 years. Results: The study population consisted of 408 males and 171 females with a mean age of 35.9 (SD: ±16.3) years. The age group 20–29 years accounted for the largest subgroup in both sexes. The most common cause of the fractures was traffic related, followed by violence. There were mainly mandibular and zygomatic bone fractures in both males and females, accounting for approximately 80% of all fractures. The main fracture site of the mandible was the combination of mandibular body with mandibular condyle (66 patients; 26.8%), followed by the combination of bilateral condylar fracture and fracture of the symphysis (43 patients; 17.5%). In fractures of the upper 2/3 of the face, zygomatic bone fractures were most common. In patients with alcohol consumption the injury was mostly the result of violence. In conclusion, this report provides important data for the design of plans for injury prevention, as compared with previous studies. Violence related injuries are increasing whereas fractures caused by traffic accidents are decreasing. [Copyright &y& Elsevier]

Economic aspects of possible land use strategies and protection measures in coastal zones as a response to global environmental change are examined. First, some key elements are mentioned that are of critical importance for water and land management in coastal zones. Next, various socio-economic repercussions are discussed. In this context, research needs will be addressed. Subsequently, these issues are considered for the case of The Netherlands. It is concluded that integrated modelling and analysis is just starting and needs to receive more attention in order to study long run economic costs, benefits and changes in coastal zones. [ABSTRACT FROM AUTHOR]